Cardiovascular (CV) disease is the leading cause of mortality in systemic lupus erythematosus (SLE). The risk of myocardial infarction (MI) in SLE is twice the incidence and ten years earlier in onset than in the general population. We present the first known case in the Philippines of acute MI from triple vessel coronary artery disease (CAD) in a young female patient with SLE. This aims to increase recognition and improve preventive strategies for this rare lupus complication. A 31-year-old female with SLE for thirteen years, antiphopspholipid syndrome (APS) and controlled hypertension (HTN) presented with acute chest pain, diaphoresis, and dyspnea. She was a non-smoker with quiescent lupus and nephritis, maintained on low-dose aspirin, mycophenolate mofetil and hydroxychloroquine for the past four years. The physical examination revealed hypertension, bradycardia, normal heart sounds without murmurs, and no signs of lupus flare. The troponin level was elevated, and the electrocardiogram showed inferior wall ST-segment elevation myocardial infarction (STEMI). Coronary angiography revealed triple-vessel disease, with 80-90% stenosis of the left circumflex artery, and total occlusion of the left anterior descending and right coronary artery. There were segmental wall motion abnormalities and a low ejection fraction of 44% on echocardiography. The complete blood count, urinalysis, and serum C3 were within normal range. The anti-dsDNA was low and lipid levels were abnormal. The patient refused coronary artery bypass grafting (CABG). Medical management consisting of anti-platelets, beta-blockers, statin, and warfarin was maximized. The patient completed one year of follow-up without any lupus flares or cardiovascular events. This case illustrates the complex interaction of disease-related and traditional cardiovascular risk factors leading to premature coronary artery disease in a young female with SLE. The case demonstrates favorable one-year outcomes after optimized post-MI medical management. Aside from optimized lupus control and reduced glucocorticoid use, proactive screening and aggressive management of modifiable CV risk factors and antiphospholipid antibodies (aPL), are necessary.
Human ; Female ; Adult: 25-44 Yrs Old ; Lupus Erythematosus, Systemic ; Myocardial Infarction ; Literature ; Infarction ; Female

Academic publishing is at a critical juncture. The challenges faced by the academics are mired in controversy. Among theseare three hotly debated concerns. First is the issue of whether technological innovations such as artificial intelligence (AI)improves research efficiency or if its use sacrifices research integrity.Another is the controversy between paywall publishingand open access. Lastly, adapting an appropriate business model for sustainability is a contentious issue and the choice betweena commercial or a university-based publishing platform is a difficult one.

Traditional models of scientific investigation relied on tedious intellectual calisthenics in all aspects of research —identifying research gaps, reviewing of published literature, devising valid methodology, collecting data, analysing results, and,finally, drawing conclusions. With the advent of powerful tools employing artificial intelligence, these heavy tasks are efficientlycarried out. The dilemma lies in determining which parts of the work can be attributed to the authors and which are ascribedto the output of large language models (LLMs) and other automated assistance employed.Despite requiring adequate vettingby experts of these AI-aided output, many in the scientific community still question these methods. Can research employingAI be considered honest work? Will full disclosure answer doubts as to the integrity of the scientific work?

Indeed, LLMs just gather information that is already out there, albeit more efficiently. After all, science progresses bystanding on the shoulder of giants. AI makes such work comprehensive and efficient. Standing on those proverbial shoulders,however, require access to prior work, hence our next challenge in academic publishing--open access versus paid access.Paywalls limit the benefits of valuable research to institutions and universities with the capacity to pay. Excluded from these arethose from low resourced countries, with nations from the global south being affected disproportionately. Additionally, whilenumerous authors appreciate the features of open access as it improves their impact and visibility, many feel unduly burdenedsince the cost of publishing in this format is passed on to them.

This brings us to our third issue: who bears the cost of academic publishing? Indeed, it is a lucrative industry, generatingan annual revenue of US$19 billion and an estimated 40 percent profit margin. Many, however, find fault in this businessmodel as concerns about the profit motives of the commercial publishers far overshadow their sustainability goals.

How do we navigate this landscape of controversies? We, at the ACTA, as part of the community of scholars, would needto clarify our mission. Our goals for this publication should be consistent with our values. These values, such as scientific rigor,integrity, and accountability, should be reflected in our policies. We should be cognizant of the role we play in national scientificdiscourse while we endeavor to make an impact in the global scene. We are accountable to our stakeholders — nurturingearly career scholars, supplying evidence to health policymakers, and being accountable to those who provide resources tosustain us. This stewardship is essential so that ACTA will stand shoulder to shoulder with the giants on which science buildsupon to benefit future generations.

Artificial Intelligence ; Commerce ; Costs And Cost Analysis ; Disclosure ; Drawing ; Efficiency ; Family Characteristics ; Forecasting ; Goals ; Gymnastics ; Health ; Health Resources ; Industry ; Intelligence ; Inventions ; Language ; Literature ; Methods ; Play And Playthings ; Policy ; Publications ; Publishing ; Research ; Residence Characteristics ; Role ; Science ; Shoulder ; Social Responsibility ; Universities ; Ursidae ; Volition ; Work ; World Health Organization

OBJECTIVES

The increasing prevalence of Kawasaki disease in Southeast Asia (SEA) and its potential relation with Coronavirus Disease 2019 (COVID-19) infection resulted in heightened interest in KD in the region, thus, this paper aimed to determine the trend and the socioeconomic facilitators of scientific productivity of KD research within the region. Specifically, this article determined the number of publication and citations related to KD per country, institution, and journal. We also explored the networks of countries within the region to the rest of the world and the keywords mostly associated with KD research in the region. Lastly, correlation of these bibliometric indices with socioeconomic factors in the region was analyzed.

METHODS

A literature search of KD papers in SEA was performed using Scopus database. We obtained bibliographic data from the available literature and visualized network of existing collaborations and keywords using VOSviewer software.

RESULTS

A total of 196 papers were included in the study. Bibliometric analysis showed a rising trend in publication within the region, most of which were from institutions in Singapore and Thailand. The most common topics on KD studies included clinical features, complications, treatment, and comorbidities. 

Country characteristics such as gross domestic product (GDP) per capita, research and development (R&D) expenditure (% GDP), and number of physician and R&D researchers were positively correlated with bibliometric indices of KD research in SEA. Moreover, number of international linkages was significantly associated with KD research productivity in the region. 

CONCLUSION

In summary, we showed an increasing trend of KD research in SEA. Funding allocation and capacity building are necessary to strengthen research productivity within the region.

Asia ; Asia, Southeastern ; Bibliometrics ; Capacity Building ; Coronavirus ; Covid-19 ; Database ; Disease ; Efficiency ; Gross Domestic Product ; Guanosine Diphosphate ; Infection ; Infections ; Literature ; Mucocutaneous Lymph Node Syndrome ; Paper ; Physicians ; Prevalence ; Publications ; Research ; Research Personnel ; Rest ; Singapore ; Socioeconomic Factors ; Software ; Thailand ; Therapeutics

Introduction: Gestational diabetes mellitus (GDM) is a common pregnancy complication associated with adverse maternal and neonatal outcomes, including hypertensive disorders, caesarean delivery, macrosomia, and increased lifetime risk of type 2 diabetes. Despite its clinical importance, considerable international variation exists in GDM screening and diagnostic criteria. Multiple frameworks are currently used, including those from the World Health Organization (WHO), International Association of Diabetes and Pregnancy Study Groups, Carpenter and Coustan, and the National Diabetes Data Group. Differences in glucose thresholds, testing protocols (one-step versus two-step), and universal versus risk-based screening contribute to heterogeneity in reported prevalence and healthcare burden. In multi-ethnic, middle-income settings such as Malaysia, identifying an evidence-informed and contextappropriate diagnostic approach is critical. Methodology: This scoping review follows the Joanna Briggs Institute methodology and will be reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). PubMed, Scopus, and ScienceDirect will be searched for English-language studies, reviews, guidelines, and consensus statements reporting GDM diagnostic criteria. Two reviewers will independently screen and select studies. Results: Data will be charted on country, study type, diagnostic criteria, gestational age at screening, and reported challenges. Findings will be synthesized descriptively and presented in tables and figures. No formal risk-of-bias assessment will be conducted. Conclusion This review will provide a comprehensive overview of global diagnostic practices, highlight variations and gaps, and support evidence-based selection of a suitable GDM screening and diagnostic strategy for Malaysia.
Diabetes, Gestational ; Malaysia ; Policy ; Review Literature as Topic

Professor LI Zhidao puts forward the application of "group acupoints" in his clinical practice by imitating the mutual reinforcement and mutual assistance of Chinese herbal medicine. It is based on the theory as "where is the acupoint located, what are the indications of this acupoint"; and consists with the specific actions of ancient needling techniques at acupoints. The distribution of "group acupoints" is in line with the "located by the region division of the head and trunk, and by the meridians on the four extremities", which is recorded in Zhenjiu Jiayi Jing (the Systematic Classic of Acupuncture and Moxibustion). It shows "the importance of the relationship between acupoints and zangfu", and "the emphasis on the distribution of nerves and muscles" respectively. In clinical practice, controlling needling sensation is the essence of this technique at "group acupoints", the integration of acupoints and needling technique is the basic requirement, and the step-by-step needling manipulation is critical for obtaining the therapeutic effect. "Group acupoints" combined with specific needling technique advance the application efficiency and the effect of acupoints.
Acupuncture Points ; Acupuncture Therapy/methods* ; Humans ; China ; History, 20th Century ; Meridians ; Medicine in Literature ; Acupuncture/history*

The paper introduces Professor ZHUANG Lixing's academic thought on Daoqi Tongjing (directing qi to preserve essence) needling technique and the clinical experience. Based on Huangdi Neijing (the Yellow Emperor's Inner Classic), Dongyuan needling technique and Professor JIN Rui 's Daoqi Tongjing needling method, and by inheriting the valuable experience from the ancient masters and associating with his own clinical practices, Professor ZHUANG Lixing fully displayes the characteristics of principles, methods, formulas, acupoints and techniques of acupuncture in diagnosis and treatment of diseases. He integrates the thought of regulating the mind with Daoqi Tongjing needling. This needling method focuses on directing qi through mind regulation and needle manipulation, in which, the operation steps are refined. Besides, this needling method involves both the reinforcing and reducing techniques. The satisfactory effect of this needling has been obtained in clinical treatment for many disorders such as qi reversion and disharmony of yin and yang.
Acupuncture Therapy/instrumentation* ; Humans ; Acupuncture Points ; China ; Qi ; History, Ancient ; Medicine in Literature

By analyzing the understandings of water points (acupoints connected with the kidney) and its association with water (kidney), zangfu organs and meridian-collateral recorded in Suwen: Shuire Xue Lun (Discussion on Water and Heat Diseases in Plain Question), it is found that the recognition on the water points is different from that on water diseases in Huangdi Neijing (the Yellow Emperor 's Inner Classic). The recognition on the water points focuses on the core theory, "rooted at the kidney", to explain the water diseases. Besides, in association with the study on the connotation of "luo" in Huangdi Neijing, it is discovered that "yinluo" discussed in water points is actually the misunderstanding of "zang zhi yinluo" that means "the connection by the kidney". It is shown that the discussion of water points refer to the elaboration of zangfu organs and 57 acupoints connected with water (the kidney), rather than the theory of collaterals. The characteristics of these 57 acupoints involved and the related needling techniques provide a new approach to the treatment of zangfu diseases.
Acupuncture Points ; Humans ; Meridians ; China ; History, Ancient ; Medicine in Literature ; Medicine, Chinese Traditional/history* ; Acupuncture Therapy/history*

In Weisheng Baojian (Treasures on Health), the compatibility of Qihai (CV6) and Zusanli (ST36) was widely used in the medical cases treated with acupuncture and moxibustion. Through analyzing the medical cases and summarizing the rules of acupoint compatibility, it is found that LUO Tianyi's idea of moxibustion at these two acupoints was different from the other medical masters. He combined these two acupoints in line with "spleen and stomach theory", rather than from the perspective of the direct relationship of acupoints with syndromes and zangfu organs. It reflects the diversity in the understanding of the human body and diseases among medical masters. Therefore, in order to analyze the representative understandings of ancient medical masters on the connotation and rules of acupuncture and moxibustion, we cannot simply focus on the summary from acupuncture-moxibustion masters. It is suggested that the analysis should be expended in the entire field of traditional Chinese medicine to explore the general rules of treatment with acupuncture and moxibustion, investigate the differences, and deepen the basic reasons of the distinction.
Moxibustion/history* ; Humans ; Acupuncture Points ; Acupuncture Therapy/history* ; China ; History, Ancient ; Medicine in Literature ; Medicine, Chinese Traditional/history*

The paper introduces 5 books written by WANG Mengying, including Suixiju Chongding Huoluan Lun, Guiyan Lu, Wenre Jingwei, Wang Mengying Yi'an and Suixiju Yinshipu; and analyzes the ideas of diagnosis and treatment of cholera and the academic thoughts in treatment with acupuncture-moxibustion therapy. In pathogenesis, cholera is classified into cold and heat types. Cholera of heat type roots on qi and blood. If the pathogenic factors are mild and located shallowly, the sneezing method, followed by scraping method, is adopted to open meridians and collaterals, as well as the qi level, so as to eliminate pathogens. When the pathogens go deeply, the bloodletting technique is used to clean the toxic heat in blood level and reduce the reversed qi. For cholera of cold type, warm ironing moxibustion is delivered to promote qi circulation and disperse cold, and improve qi movement. If spasm and syncope occur in cholera, no matter of cold or heat identification, the emergent measure is operated with the external application of pungent, warm and salty herbal plaster at Yongquan (KI1). When the pathogens are almost eliminated, the herbal medicines are combined to treat the symptoms and remove the causative factors of the disease.
Acupuncture Therapy/history* ; Moxibustion/history* ; Humans ; Cholera/history* ; China ; History, Ancient ; Medicine in Literature ; Books/history*

It attempts to determine the theoretical connotation and clinical application of the twelve-meridian based syndrome/pattern differentiation of TCM through the systematic analysis and elaboration, so as to promote the completion of meridian differentiation system. The exploration is conducted on the main body of traditional meridian-syndrome differentiation, meaning the meridian differentiation in terms of location of illness and that in terms of symptoms. The existing problems and causes are analyzed, and the specific methods of meridian differentiation put forward in line with the characteristics of meridian distribution and symptoms. In reference with Huangdi Neijing (Yellow Emperors' Canon of Medicine) and other ancient literature, the theoretical evidences of meridian differentiation are deeply analyzed in view of physiological/pathological characteristics that has been neglected in the past, such as qi and blood of meridians, opening, closing and pivoting, and time. Additionally, the category issues related to twelve-meridian differentiation and their relationship with six-meridian differentiation are expounded. The summary on the multiple connotations of twelve-meridian differentiation is of great significance on re-understanding meridians, perfecting meridian-collateral differentiation system and improving the accuracy on meridian-based treatment. Besides, the reconstruction of meridian differentiation and its framework is considered profoundly.
Meridians ; Humans ; Medicine, Chinese Traditional ; Acupuncture Therapy ; Diagnosis, Differential ; History, Ancient ; Acupuncture Points ; Medicine in Literature